CLINICAL AND RADIOGRAPHIC OUTCOMES IN OPERATIVE VS NONOPERATIVE TREATMENT OF HUMERAL SHAFT FRACTURES
Recommended Citation
James C, Haan JW, Wager SG, Hegde YD, Wolterink TD, Muh S. CLINICAL AND RADIOGRAPHIC OUTCOMES IN OPERATIVE VS NONOPERATIVE TREATMENT OF HUMERAL SHAFT FRACTURES. JSES International 2023; 7(5):1808.
Document Type
Conference Proceeding
Publication Date
9-1-2023
Publication Title
JSES International
Abstract
Background: Humeral shaft fractures represent 1-5% of all fractures and are increasing in incidence. There is conflicting literature regarding the superiority of operative versus nonoperative treatment of these fractures. We hypothesized that patients treated operatively would have a faster time to radiographic union and improved functional outcomes relative to patients treated nonoperatively. Methods: This was a retrospective cohort study performed at a single healthcare system. All humeral shaft fractures treated between 2010-2020 were identified using ICD-9, -10, and CPT codes. Information on demographics, fracture, treatment, and outcomes was collected through chart and radiograph review. These measures were compared between patients treated operatively and nonoperatively. Results: A total of 517 adult patients with unilateral humeral shaft fractures were identified, 233 were treated nonoperatively and 284 were treated operatively. Patients treated operatively had a mean age of 50.2 years relative to 59.9 years in patients treated nonoperatively (p < 0.001). A higher proportion of the nonoperative group were female and unemployed than the operative group (p = 0.007 and p < 0.001 respectively). Operatively treated patients had significantly faster time to radiographic union at a median of 113 days versus a median of 161 days in nonoperatively-treated patients (p = 0.001). The operative group was made weight-bearing as tolerated at a median of 84 days, significantly less time than the nonoperative group at a median of 98 days (p = 0.002). There was no difference in complication rates between groups. There were no differences in range of motion at time of radiographic union. However, at time of last follow-up, patients treated operatively were up to two times more likely to achieve full shoulder forward elevation than those treated nonoperatively (p = 0.011). Conclusions: Operative treatment of humeral shaft fractures leads to faster time to union and earlier weight bearing without increased rate of complications.
Volume
7
Issue
5
First Page
1808
